University of Arizona College of Nursing Assistant Professor Tracy E. Crane, PhD, has focused much of her career on cancer survivorship. With a research focus on improving adherence to healthy lifestyle behaviors in cancer survivors and their informal caregivers, she has developed interventions geared toward extending the lifespans of post-treatment ovarian cancer survivors, and telephone counseling to improve diet and physical activity in Latina cancer patients. At the beginning of the year, Dr. Crane extended her expertise across the Atlantic when she helped researchers at Gustave Roussy, Europe’s largest cancer center, fine-tune a new cancer study, Motivating to Exercise and Diet, and Educating to Healthy Behaviors After Breast Cancer (MEDEA).
In keeping with Dr. Crane’s previous research, MEDEA aims to compare the effect of a personalized telephone-based health education weight loss program based on motivational coaching, exercise and diet versus a standard health educational program control on fatigue of overweight or obese breast cancer patients.
"You can teach in another language and help people understand the basics of behavior change and how to intervene, particularly with cancer survivors. This is really the first step in many more iterations of research that follow from this," ~ Tracy Crane, PhD
“Arizona is becoming known for doing these telephone-based interventions for cancer survivors,” says Dr. Crane, who was contacted by MEDEA coordinating investigator Ines Vaz Luis, MD, MSc, because of her involvement with Dana Farber Cancer Institute’s Be-Well program. Dr. Crane is a consultant on the Institute’s 3,000-person weight loss trial for breast cancer survivors, which examines telephone-based intervention examining weight loss and the progression of disease – a program Dr. Luis hoped to replicate in France around issues of weight loss and fatigue in cancer survivors. “They called me because I had trained all of the coaches on the Be Well study,” says Dr. Crane. “They asked me to come over and collaborate on training the French coaches for the MEDEA study.”
Dr. Crane’s visit to Gustave Roussy, which is located in South Paris, was a whirlwind of activity. “I left Sunday, arrived Monday, got over jetlag and then Tuesday I started working,” she says. “I literally worked Tuesday to Friday. People asked, ‘Didn’t you love Paris?’ and I said, ‘I didn’t even see Paris. I was at the Cancer Center.”
Dr. Crane trained MEDEA staff in the in basics of nutrition, weight loss, motivational interviewing and behavior change. She also supervised the implementation of various corded role-playing phone calls where staff pretended to be patient participants and patient advocates to fine-tune the rhythms of the intervention.
“I used a very similar protocol I’ve used for several studies,” says Dr. Crane. “You train people didactically, and then you put them into mock scenarios. After that, we listen to the call together, give feedback, and then we do another one.”
After the intensive training sessions, Dr. Crane says, her colleagues in the MEDEA program were ready to begin the project in earnest. “They had a little more follow-through practice to do after I left, but they’ll be ready to talk to actual participants,” she says. Thanks to her guidance, the program plans to enroll patients from all across France by April of this year.
As for the future, Dr. Crane plans on future trans-continental journeys to assist further with the MEDEA program. Her work will benefit not only her colleagues in France, but render evidence for the efficacy of her research program in broader terms that will also benefit UArizona Nursing. In the long run, she is curious to see if the Be Well study can be replicated in another country and to gather more evidence supporting the necessity for these kinds of lifestyle interventions for cancer survivors.
“Right now, not everybody gets this,” says Dr Crane. “But should everybody be getting this? Do they have fewer readmissions? Do they have fewer illnesses? Fewer problems long-term? Toxicities that are a result of cancer? Are all of those impacted by this intervention? Because with answers to those questions, then we can begin to take that data and say, ‘Look, we need to offer some kind of program across the board.’”
In the meantime, Dr. Crane is proud of the outreach she’s done with the MEDEA program and hopeful that it will ultimately be implemented in larger ways that benefit even more cancer survivors and their informal caregivers. “The biggest takeaway is that people are motivated to make these changes,” she says. “You can teach in another language and help people understand the basics of behavior change and how to intervene, particularly with cancer survivors. This is really the first step in many more iterations of research that follow from this.”